Purchase this article with an account.
S. Park, D. Moss, J. B. Davies, A. Sheybani, J. Hou, K. Blinder, G. K. Shah; Low Rate Of Surgical Complications Associated With Two Step 23 Gauge Pars Plana Vitrectomy. Invest. Ophthalmol. Vis. Sci. 2009;50(13):4203.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To assess the complication rates associated with the 2 step pars plana vitrectomy in vitreoretinal disease
Retrospective, consecutive, interventional case series of 586 eyes of 586 patients who underwent 23-gauge vitrectomy from January 2005 to February 2008 in a single academic center using the D.O.R.C. two-step entry system. Patients were examined on post-operative day 1 and then approximately on post-operative weeks 1 and 4 and had a minimum follow-up time of 6 months. Demographic information and clinical data were recorded and analyzed. Main outcome measures were best-corrected Snellen visual acuity, intraocular pressure (IOP), and intra-operative and post-operative complications.
Indications for vitrectomy surgery included vitreous hemorrhage, diabetic retinopathy, diabetic macular edema, cystoid macular edema, retinal vein occlusion, uveitis, epiretinal membrane, vitreomacular traction, rhegmatogenous retina detachment, and macular hole. Sutures were required to close sclerotomy sites in less than 10% of eyes. At the conclusion of surgery, eyes were filled with either intravitreal air, gas, or silicone oil. No eyes were left with a complete fill of balanced salt solution. The incidence rates of surgical complications were as follows: high intraocular pressure on the first post-operative day (IOP > 30 mm Hg) 23/586 (3.9%), hypotony (IOP ≤ 5 mm Hg) 8/586 (1.4%), vitreous hemorrhage 3/586 (0.5%), recurrent rhegmatogenous retina detachment 2/586 (0.3%), macular hemorrhage 1/586 (0.2%), hyphema 1/586 (0.2%), and endophthalmitis 1/586 (0.2%). No intra-operative complications were reported.
The incidence of intra-operative and post-operative complications associated with 23-gauge vitrectomy was low in this series and compares well to published data for 20 gauge surgery. The stability and reliability of the 2 step 23 gauge wound system is responsible for the low rate of complication seen in this series.
This PDF is available to Subscribers Only